If you are currently struggling with addiction to drugs or alcohol and have tried a traditional abstinence-based treatment, you may want to consider a harm-reduction model. For some people, a harm-reduction model is more effective than an abstinence-only treatment approach.
The harm-reduction model is not new, but it is less frequently used in addiction. Many treatment approaches are centered around abstinence, which may not be effective for everyone. First, an abstinence-only approach may be overwhelming for those with substance use and abuse histories, which can lead them to avoid treatment in the first place. Additionally, the known issues related to withdrawal and substance cravings can be an intimidating topic. The goal of harm-reduction is to minimize the harm associated with using a substance, which may include reducing substance use over time. Another potential advantage with harm-reduction programs is they are usually not faith based, which can make more people feel welcomed into the program and addiction center without the fear of judgment.
Use of Medications
Many harm-reduction programs continue to integrate medications to reduce cravings or the pleasure associated with using a substance. For example, naltrexone is used in many forms of addiction treatment, including harm-reduction programs. Naltrexone helps by desensitizing regions of the brain associated with the pleasurable effects of using drugs, and this can make you less likely to use the drug. Although there are benefits to using these medications, they only work if you continue to take them. Some people "fall off the wagon" and stop taking their medications to regain the benefits of using.
Integration of CBT
Cognitive behavioral therapy (CBT) is an important component of harm-reduction because it focuses on the cognitive and behavioral aspects of addiction. CBT can help people develop the coping skills necessary for the short-term and long-term management of addiction. One central element in CBT is recognizing environmental or mental stimuli that may induce cravings. For example, drug and alcohol use may be a social event for some people. This can lead to intense cravings for the substance when they are around certain people or in specific places, such as nightclubs and parties. Learning to recognize this pattern can help during treatment by trying to avoid a known stimulus.
Similarly, mental-health aspects can be a stimulus, such as feelings of anxiety or depression. Mental illness is a common occurrence with substance-use disorders. When CBT is combined with psychotherapy and possibly psychiatric medications, these negative feeling may be reduced, thereby reducing substance cravings.
One aspect of some abstinence-based programs is the stigma placed on the substance user and their families. People who have a substance-use disorder may find it difficult to accept the lifelong label of being an alcoholic or addict. Although addiction is often a lifelong battle against relapse, it may not be helpful to everyone in recovery to hear these labels. Unfortunately, to the person in recovery, it may feel like they can never move forward from their past. For the family and friends who are supporting their loved one, it is often hurtful to be seen as a person who has enabled the drug or alcohol use. The labeling and stigma can often put an unfair burden on loved ones who are only doing their best to help.
Since the goal of harm-reduction is not abstinence, the model itself reduces stigma because it redefines success. People who have gone into an abstinence-based treatment plan and could not abstain from substance use may feel like a failure. The goal of harm-reduction is to take "baby steps" and use less of a substance, possibly leading to abstinence. If a person in recovery occasionally uses drugs or alcohol, but less than before, or does not use to the extent of losing their job or making bad decisions, this is still an improvement.
Although there is no perfect treatment method for staying off drugs or alcohol, if you have tried abstinence-based programs without sufficient results, it may be time to try a different approach. Harm-reduction is one such approach that might offer you a better long-term outcome.